Older people

Older People With Type 2 Diabetes See Growing Cancer Burden

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Has cancer overtaken CVD as a leading cause of death in people with T2D?

A photo of a senior man checking his blood sugar with a glucose meter at home.

Older people with type 2 diabetes faced a higher burden of cancer mortality in recent years, according to a U.K. study.

In a cohort of over 137,000 individuals with type 2 diabetes, all-cause mortality rates dropped among all age groups from 1998-2018, reported Suping Ling, PhD, of the University of Leicester in England, and colleagues.

However, this was juxtaposed by an increase in cancer-related morality rates for people ages 75 and 85 with type 2 diabetes, they wrote in Diabetologiaopens in a new tab or window.

During the median follow-up of 8.4 years, those ages 75 with diabetes saw a 1.2% average annual percentage change (AAPC) in cancer mortality rate, while those ages 85 saw a 1.6% bump each year. On the other hand, those ages 55 and 65 saw a respective 1.4% and 0.2% annual drop in cancer mortality.

Ling’s group examined who was most impacted by this rising cancer mortality rate, and reported that people with morbid obesity (BMI 35-plus) saw one of the highest annual increases of 5.8%. Comparatively, those with a normal body weight (BMI 18.5-24.9) with type 2 diabetes only saw an average 0.7% increase.

Additionally, there was a 1.5% AAPC in cancer mortality for women versus a 0.5% increase for men. The authors noted that “[a]ll-cancer mortality rates and proportions of cancer deaths were higher in men than women for most of the 1998-2018 period, with the gap in both rates and proportions being smaller around 2012-2014 and widening since 2014.”

There also appeared to be an increasing trend in cancer mortality rates for former or current smokers (0.6% and 3.4%, respectively), as well as white individuals (2.4%), whereas downward trends were seen for nonsmokers (-1.4%) and other ethnic groups (-3.4%).

And those living in the least deprived areas saw a 1.5% AAPC compared with a 1% increase for those living in the most deprived areas.

Certain cancer-specific mortality trends emerged among this population with diabetes. Compared with the general population, there were significantly higher standardized mortality ratios (SMRs) for several cancer types among people with type 2 diabetes from 1998-2018:

  • Colorectal: SMR 2.40 (95% CI 2.26-2.54)
  • Pancreatic: SMR 2.12 (95% CI 1.99-2.25)
  • Liver: SMR 2.13 (95% CI 1.94-2.33)
  • Endometrial: SMR 2.08 (95% CI 1.76-2.44)
  • Lung: SMR 1.04 (95% CI 1.00-1.08)
  • Breast in women: SMR 1.09 (95% CI 1.01-1.18)

“The prevention of cardiovascular disease has been, and is still considered, a priority in people with diabetes. Our results challenge this view by showing that cancer may have overtaken cardiovascular disease as a leading cause of death in people with type 2 diabetes,” stated Ling’s group.

“Cancer prevention strategies therefore deserve at least a similar level of attention as cardiovascular disease prevention, especially for colorectal, pancreatic, liver and endometrial cancer, whose mortality rates were substantially higher in individuals with type 2 diabetes than in the general population,” they added.

“Persistent inequalities in cancer mortality rates by sociodemographic factors and widening disparities by smoking status suggest that tailored cancer prevention and detection strategies are needed,” they said. “For example, some subgroups such as smokers experienced not only higher mortality rates but also increasing mortality trends during the study period.”

For the population-based study, the researchers drew upon data on 137,804 newly diagnosed adults, ages 35 and older, with type 2 diabetes in the Clinical Practice Research Datalink. Those with type 1 diabetes were excluded.

The average BMI was 30.6, 55% were men, and 83% were white. Nearly half were nonsmokers and about a third were ex-smokers.

Older people ‘should exercise to build muscle even into their 80s’

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Older people should exercise to build their muscles even into their eighties, according to a new review which suggests it will help them with everyday tasks.

Senior man, woman, couple exercising: Older people 'should exercise to build muscle even into their 80s'

Today’s over-50s are very different to the over-50s of previous generations

Climbing the stairs, housework, walking and even washing were made easier if elderly people worked out two or three times a week, researchers found.

People lose muscle as they age, which can make daily chores more difficult.

But working out by using small weights or elastic bands can help to rebuild these muscles, a review of the available evidence shows, while the risks of developing an injury are low for older people.

Chiung-ju Liu of the Department of Occupational Therapy at Indiana University, who carried out the study, said: “Older adults seem to benefit from this type of exercise even at the age of 80, and even with some type of health condition.

“The data support the idea that muscle strength is largely improved after the training, and the impact on older adults’ daily activities can be significant.

“Simply having enough strength to do things such as carrying groceries would make a difference for senior (citizens).”

The study, published by the Cochrane Library, looked at 121 trials, involving 6,700 people over the age of 60, all of whom exercised between two and three times a week.